Hysterectomy Options

Hysterectomy Facts

Approximately 60 percent of those women will experience a prolonged recovery due to traditional open surgical methods

Hysterectomy is the second most common major surgery among women in the United States

Hysterectomy is the surgical removal of the uterus

Surgical removal of the ovaries (oophorectomy) is often performed at the same time

Hysterectomy can be a treatment option for women experiencing

Fibroids

Endometriosis

Prolapse

Uterine cancer

Abnormal uterine bleeding

Types of Hysterectomies

Open or “traditional” procedures

Minimally invasive procedures (MIP)

Total Abdominal Hysterectomy (TAH)

Also known as “traditional” or “open” procedure

Large incision or “bikini cut” (4–6 inches) in the abdomen to gain access to the inside of the body and provide an open view of internal organs

Tissues of the abdominal wall are stretched apart and uterus is removed

Total Abdominal Hysterectomy (TAH)

Requires three to five day hospital stay

Normal activity can usually resume in six weeks

Minimally Invasive Procedures

Two types of minimally invasive procedures (MIP) for hysterectomy

Vaginal hysterectomy

Laparoscopic procedures

Laparoscopically assisted vaginal hysterectomy (LAVH)

Laparoscopic superacervical hysterectomy (LSH)

Vaginal Hysterectomy

Incision (approximately 1 inch) made at the top of the vagina

Uterus and cervix are separated from the body and removed through the vagina

Abdominal walls are not stretched

Requires one to three day hospital stay

Normal activity can usually resume in four weeks

Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

Incision (approximately 1 inch) made at the top of the vagina

Uterus and cervix are removed through the incision

Prior to removal, a laparoscope (miniature camera) is inserted through a small abdominal incision to view the uterus and surrounding organs

Uterus is detached under view of the laparoscope using special laparoscopic surgical tools inserted through small incisions

Requires one to three day hospital stay

Normal activity can usually resume in four weeks

Laparoscopic Supracervical Hysterectomy (LSH)

Uterus is removed using only laparoscopic tools

Using instruments, the surgeon separates the uterus from the cervix and removes it through one of the abdominal incisions

Requires one to three day hospital stay

Normal activity can usually resume in four weeks

The LSH procedure uses a thin, lighted telescope-like instrument called a laparoscope, which acts like a video camera, along with small surgical instruments that are all inserted through three to four tiny incisions (less than ¼ inch each) in the navel and abdomen. Using the instruments, the surgeon carefully separates the uterus from the cervix and removes it through one of the openings. The cervix, the bottom part of the uterus, is left intact. Because this type of surgery does not require the surgeon to make a large abdominal incision, you will not have the same kind of visible scar typical with most traditional, “open” surgeries.

Some research suggests that preserving the cervix may help to reduce the risk of pelvic floor prolapse, urinary incontinence and other complications associated with total hysterectomies. However, with the cervix in place, it means that following an LSH, you must be willing to continue getting annual Pap smears to screen for cervical cancer. In addition, this procedure may not be appropriate if you have large or numerous fibroids. Download Brochure

Why Consider a Minimally Invasive Procedure

Most MIP patients have*

Quicker recovery

Less time in the hospital

Less post-operative pain

Less scarring

Risks and Complications

Both types of hysterectomy — traditional and MIP have risks including:

Reactions to medications or problems resulting from anesthesia

Breathing problems

Bleeding

Infection

Blood clots in the veins or lungs

Death (rare)

Inadvertent injury to the organs and vessels near the uterus

Risks Specific to Traditional Hysterectomy

Muscle injury

Post-operative incisional hernia

Discuss the Options With Your Physician

Understand the reasons why you may need your uterus removed

Find time to discuss the surgery away from the examining room when you are fully dressed and comfortable

Bring questions and take notes

Consider including a friend or family member in the discussion

Questions to Ask Before Your Hysterectomy Procedure

How long will it take me to recover?

When will I be able to leave the hospital?

Will my ovaries or any reproductive organs other than my uterus be removed?

When can I resume normal activities, including school, work, exercise, sexual activity, and recreation?

What type of hysterectomy will I have?

Is any type of minimally invasive procedure appropriate for my situation?

Which organs will be removed?

Exactly where, and how big will the incisions be?

Is this the least invasive procedure available for my condition?

How many of these procedures have you performed in the past 12 months?

Choosing MIP over Traditional Surgery

Your surgeon will help you determine if MIP is an appropriate choice for you